Forty-four-year-old Nathan Verhelst was born as Nancy Verhelst into a family which despised girls. "When I saw 'Nancy' for the first time, my dream was shattered,” her mother told the Het Laatste Nieuws newspaper. “She was so ugly. I had a phantom birth. Her death does not bother me.”

Unsurprisingly, Nancy grew up hating her femininity. Four years ago she embarked upon a course of hormone therapy and last year she had her breasts surgically removed and underwent surgery to construct a penis. Belgian media showed images of Nathan, Nancy’s masculine alter ego, now tattooed with a shaven head, sun-bathing on a beach.

But the operations did not work. "I was ready to celebrate my new birth," he told Het Laatste Nieuws. "But when I looked in the mirror, I was disgusted with myself. My new breasts did not match my expectations and my new penis had symptoms of rejection. I do not want to be... a monster."

Nathan’s solution was to seek euthanasia. He sought the help of Dr Distelmans. After studying his case and giving him six months of counselling, Dr Distelmans and his team decided to grant his request because it fulfilled all the conditions of the law. Although Nathan was not terminally ill, he was experiencing unbearable psychological suffering. Two other doctors agreed, one of them a psychiatrist. And on September 30, Dr Distelmans gave him a lethal injection.

Nancy Verhelst’s doctors -- her psychiatrist, urologist, gynaecologist, and cosmetic surgeon -- had destroyed her life. But they weren’t the ones who paid the price. She did.

This is not the first time that legal euthanasia has erased the errors of the medical profession in Belgium.

Earlier this year the well-documented case of Ann G (her full name did not become public) emerged in the media. She had suffered from anorexia nervosa for 25 years and was being treated by a psychiatrist with an international reputation for expertise in her condition, Walter Vandereycken. Instead of helping her, he sexually abused her. She accused him of this on national television. Instead of being deregistered and jailed, he went back to work in private practice. Although he was suspended by the Catholic University of Leuven (KULeuven), this amounted to a slap on the wrist. Ann G was distraught. She still had to live with “the cancer in her head” of anorexia, she had become a victim of sexual abuse, and she could get no justice.

She found a solution. Late last year she sought euthanasia.

There’s more.

Mark and Eddy Verbessem were45-year-old deaf identical twins who lived together and worked as cobblers. They were going blind and they thought that they had nothing to live for. On December 14, Dr Distelmans euthanased them. He described it with a certain sense of professional pride as the world’s first case of “double euthanasia”.

Once again patients paid the ultimate price for professional incompetence. The brothers’ situation was difficult but they were not terminally ill and were not suffering any physical pain. As deaf communities pointed out, being deaf and blind is not a death sentence. America’s best-known deafblind person, Helen Keller, travelled the world, wrote books and became an ardent propagandist for socialism.

The real problem is Belgium’s woeful social services. A recent judgement by the European Committee on Social Rights found that that its inadequate provision of care and accommodation for highly dependent persons with disabilities amounted to a violation of human rights.

In many other countries, cases like Nathan Verhelst and Ann G. would have been treated as medical malpractice cases. But this is no longer the case in Belgium! Some doctors are now effectively escaping the consequences of their patients' wretchedness because this very wretchedness has led them to ask for death. The Belgian medical profession has become judge, jury and executioner for victims of its own incompetence and indifference.

If there is one man who illustrates this whole process, it is Dr Wim Distelmans.

Distelmans is propagandist-in-chief for Belgian euthanasia. His craggily handsome features appear on the cover of national magazines and he has been honoured many times by progressive groups. He has written numerous op-eds defending euthanasia. In April last year, he was declared a “hero of autonomy” for his “pioneering” work .

Distelmans is also practitioner-in-chief of Belgian euthanasia. He has euthanased a number of patients and trains other doctors in his lethal art.

And Distelmans is also the assessor-in-chief of Belgian euthanasia. To anyone outside Belgium this must sound incredible, but in my country this is unblinkingly accepted. He helped to draft the 2002 Belgian euthanasia law and he is the chairman of the Federal Control and Assessment Commission which determines whether euthanasia cases have been carried out according to the provisions of the law.

The only argument for euthanasia which makes any sense at all in a humane society in the developed world is respect for autonomy. But after having been tested in Belgium’s living laboratory, this starry-eyed notion stands condemned as a hollow fraud.

Doctors abuse patients and then these patients autonomously ask doctors for euthanasia. How can this possibly be described as autonomy?

After sex reassignment surgery, Nathan Verhelst had a gigantic tattoo emblazoned on the left side of his chest: two fluttering swallows beneath the words “Free as a bird”. It was a lie; his doctors’ grotesque, gigantic, heartless promise was a deadly lie. And when he found out that it had been a lie, they offered him euthanasia.

In Belgium patient autonomy is for the birds.

Dr Tom Mortier lectures in chemistry at Leuven University College, in Belgium.